The Greater Baltimore Medical Center said yesterday that it would eliminate the equivalent of 124 full-time jobs because of a drop in overnight patients and competition from new outpatient centers that charge bargain rates.
All but 35 positions are vacant, and the hospital said it would try to place some of the employees receiving pink slips this week in other jobsat the hospital.
The suburban Baltimore hospital said the job cuts and other cost-saving steps, including eliminating a management Christmas party and moving to a biweekly payroll, would save $8 million and insure GBMC meets the income level planned for the year. The cuts come after a disappointing second quarter, hospital officials said, though they declined to provide specifics.
"What we are doing is reacting to what could be a temporary or permanent decline in volume," said Vivienne Stearns-Elliott, a GBMC spokeswoman, referring to a steady drop in overnight patient stays. "We are trying to put ourselves in a good position, to be sure we have a positive outcome for the end of the year."
GBMC's overnight patient census yesterday was down nearly 10 percent, to 249 patients, from the same day a year ago and 13 percent below the level anticipated, the hospital said.
GBMC's cuts affect many departments and include employees in management, billing, nursing and support staff. At the same time, Ms. Stearns-Elliott said the hospital would add staff in growth areas, such as an outpatient gynecology center opening next month.
The Towson hospital employs 2,853 people. It has the second-largest inpatient cancer program, behind Johns Hopkins Hospital, and delivered the second-highest number of babies in the state last year, behind Holy Cross Hospital in Silver Spring.
Despite five years of growth, including focusing on high-volume, high-profit specialties such as obstetrics, GBMC faces the same problems as hospitals across the country -- the movement of patients to cheaperhealth care settings prompted by insurance companies looking to slash costs.
GBMC has posted record patient growth compared with other hospitals in recent years. But like other hospitals, it has experienced steep drops recently -- 7 percent in August, for example, and gradual losses since the spring.
It is not only the loss of inpatient business, however, that prompted the layoffs.
The radiation oncology department, which offers mostly outpatient treatment, laid off seven people, or 22 percent of the department, two weeks ago, after its patient load dropped by one third. Employees affected included secretaries, technicians and nurses.
Dr. Kelly Drake, chairman of the GBMC radiation oncology department, attributed the loss of patients to an increase in the number of free-standing centers, including those on the campuses of competing hospitals, that can charge cheaper rates because they are unregulated. Hospital rates are set by the state and include a fee to care for the uninsured.
Regulated rates are, in many cases, higher than the fees charged by centers that do not treat the uninsured. One result is that insurance companies "will gravitate to the free-standing centers as long as rate regulation keeps hospitals noncompetitive," Dr. Drake said.
In recent months, at least three hospitals in Maryland have laid off employees. Most recently, Franklin Square Hospital, with 2,500 employees, laid off 35 people and eliminated 45 vacancies to save $4 million a year. Church Hospital laid off about 100 people in February.
GBMC said it had projected $191.2 million in revenues for this year, 6 percent higher than last year. But, based on a steady drop of patients in the spring and summer, it said it now expected revenues to come in 5 percent lower than planned.
It said its cost-saving plan would include:
* Moving to a biweekly payroll from weekly paychecks, for a savings of $50,000.
* Eliminating a program in which nurses work 24 hours straight with demanding critical-care patients and are paid for 36 hours. The hospital said it would save $500,000 by adding part-time nurses.
* Cutting the in-house catering budget by $400,000.
The cuts come as the hospital's holding company, Maryland Health Corp., is building a second physicians' pavilion for outpatient surgery. It will house some growing parts of the hospital, including its in-vitro fertilization program and eye clinic, both high-volume services.